SSI Appeals

• Get the following form from the Social Security office:
    “SSA-561 Request for Reconsideration”
  
  If you are appealing a denial of disability, you will also need:
     “SSA-3441 Disability Report – Appeal”
     “SSA-827 Authorization to Disclose Information to the Social Security Administration”
  
  To get the forms online go to www.ssa.gov and enter the form numbers into the search bar. Fill them out and mail or take them to your local Social Security office.
  
  To file a denial of disability appeal online go to www.ssa.gov.
   
  • look for the box that says “Disability”
  • click on “Appeal a Decision” section on the right side of screen
  • click the blue box that says “Reconsideration”
  • click the next blue box that says “Request Medical Reconsideration”
• Social Security has to get your Request for Reconsideration form within 60 days from when you got the denial notice. The 60 days start the day after you get the denial notice. Social Security assumes you got the notice 5 days after the date on the notice.
  
  If Social Security does not get your appeal papers by that date, your papers are late. If you do not have a good reason for them being late, you have to start all over with a new disability application.  
   
• If Social Security wants to cut off your benefits, you can keep getting SSI while you appeal. But Social Security has to get the Request for Reconsideration form within 10 days after you got their notice for this to happen. You have to ask for your benefits to continue. You still have a full 60 days to appeal the decision, but your SSI will stop unless Social Security gets your appeal paper within 10 days.
   

• If you don’t appeal, you lose your right to appeal. But, if you apply again within a certain time, you can ask that the first decision be re-opened, and ask for back benefits to that date.
   

You can do this yourself or get a lawyer. Call your legal aid office.

There are 3 kinds of recon: case review, informal conference, and formal hearing. Choose the one that works best for your situation. Check the one you choose on the form.

• To appeal denial of an application for disability benefits, a case review is your only choice. In a case review, you can add more evidence and facts to your file. You won’t meet with the person who reviews your file.

• To appeal overpayments, reductions, or termination of your benefits due to non-medical reasons, you can choose a formal or informal conference. A non-medical reason is something like having too much income or resources, having your name on a bank account that is not yours, or being told you got benefits you shouldn’t have gotten. You get to meet with the person who decides your appeal. The meeting is usually at the Social Security office.
• To appeal a decision to cut off your benefits (called a “cessation” of your disability), you have a right to an in-person hearing. You get to meet with a hearing officer who reviews your file. This meeting is fairly informal and usually takes place at the state Disability Determination Services (DDS) office.

• You can present witnesses. This is not your last chance at a hearing. If you lose the informal hearing at DDS, you have a right to a more formal hearing with an Administrative Law Judge (ALJ) later. You need to appeal the decision from the DDS hearing within 10 days to keep your benefits going while you wait for an ALJ hearing to be scheduled.

Be ready for your meeting. Write out a statement of the facts, including any new evidence. Tell Social Security about any new doctors, hospital stays, or medical treatments. If you are dealing with a non-medical issue, you should gather bank statements, deeds, vehicle titles, and any other important information. You have a right to look at your file before the meeting.

• Get the following form from the Social Security office:
     “HA- 501 Request for Hearing”
  
  If you are appealing a denial of disability, you will also need:
     “SSA-3441 Disability Report – Appeal”
     “SSA-827 Authorization to Disclose Information to the Social Security Administration”
  
  To get the forms online go to www.ssa.gov and enter the form numbers into the search bar. Fill them out and mail or take them to your local Social Security office.

  To file a denial of disability appeal online go to www.ssa.gov.

• look for the box that says “Disability”
• click on “Appeal a Decision” section on the right side of screen
• click the blue box that says “Hearing by an Administrative Law Judge”
• click the next blue box that says “Request Medical Hearing”

Get ready for your hearing! Look at your Social Security file. It has your medical records, statements and forms filled out by you or Social Security.

• The file is at the Office of Hearings Operations (OHO). Call (877) 512-3856 to set up a time to go see your file.
  
  If your file is electronic, you can ask for a copy on a CD. OHO has a computer you can use to look at it.
• If any of the papers in your file are wrong, or need to be explained, be ready to do this at your hearing.
• If you have new doctors’ reports or letters from employers or social workers about your ability to work, give them to OHO before the hearing.
• You can take someone with you to the hearing to testify, or just to support you.
   
• Try to get a lawyer or advocate. It is very helpful to have representation at the ALJ hearing. Call your local legal aid office.

The hearing is recorded. The judge will look at all the evidence and testimony and will mail the decision to you after the hearing. Make sure OHO has your current mailing address.

If you lose the hearing, you can ask for a review by the Appeals Council in Virginia. The appeal is not an in-person hearing. The Appeals Council does a paper review of your case.

You must file form “HA-520 Request for Review of Decision/Order of Administrative Law Judge” within 60 days of getting notice of the ALJ’s decision. Get the form from Social Security or online.

To get the form online go to www.ssa.gov and enter “HA-520” into the search bar. Fill it out and mail or take it to your local social security office.

You can also appeal online. Go to www.ssa.gov.

• click on the box that says “Disability”
• click on “Appeal a Decision” section on the right side of screen
• click the blue box that says “Request for Review by the Appeals Council”
• click the next blue box that says “Request Appeals Council Review”

Put in any new reports or evidence you have, but don’t put off filing the request because you can’t get the evidence together. File first if you have to, then send the new evidence as soon as you can. The Appeals Council gives you 25 days to submit your evidence after you file your appeal. You can also ask for more time.

The Appeals Council reviews the recording of the hearing and the papers in your file plus any new written evidence that you send. They can send the case back for another hearing, deny your appeal, or overrule the ALJ and find you eligible.

If the Appeals Council rules against you, you can appeal to federal court.

You should have a lawyer help you at this step.